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Olmstead's implementation: Differences in enforcement approaches
Andrea Avila1, William D Spaulding1, Eric A Evans2
1Department of Psychology, University of Nebraska-Lincoln.
Psychological Services
|June 10, 2021
Summary
The Olmstead decision mandates community integration for individuals with disabilities. This study found five distinct enforcement approaches across the U.S. for serious mental illness (SMI) community integration.
Area of Science:
- Public Health Law
- Disability Rights Law
- Mental Health Policy
Background:
- The Olmstead v. L.C. ex rel Zimring (1999) Supreme Court decision prohibits unjustified segregation of individuals with disabilities.
- This ruling mandates that states provide reasonable accommodations for community integration when deemed appropriate by clinicians and clients.
- Enforcement of Olmstead for serious mental illness (SMI) has varied, including Department of Justice (DOJ) settlement agreements and Third Circuit approaches focusing on state psychiatric hospital (SPH) census reduction.
Purpose of the Study:
- To empirically analyze the differential enforcement of the Olmstead decision for individuals with serious mental illness (SMI).
- To identify and describe distinct approaches to Olmstead enforcement across U.S. jurisdictions.
- To examine the legal landscape governing community integration for people with SMI.
Main Methods:
- Qualitative analysis of legal documents, including court opinions and settlement agreements.
- Comprehensive legal research across all U.S. jurisdictions.
- Identification and categorization of Olmstead enforcement strategies.
Main Results:
- Five distinct Olmstead enforcement approaches were identified across ten U.S. states.
- Enforcement strategies range from comprehensive community service development to SPH census reduction.
- Significant variation exists in how states are implementing Olmstead mandates for SMI community integration.
Conclusions:
- The enforcement of the Olmstead decision for serious mental illness (SMI) is not uniform across the United States.
- Understanding these diverse enforcement approaches is crucial for advancing community integration and disability rights.
- Further research is needed to assess the effectiveness and limitations of each identified enforcement strategy.
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